MEDICARE: JAMES ROGERS YOUNG II M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician	14197	SC

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	8157	OTHER	SC	MEDICARE PTAN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1295769438	OTHER	SC	GROUP NPI

General Provider Information

NPI Number	:	1639150766
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES ROGERS YOUNG II M.D.

Provider Business Mailing Address
First Line	:	3 SAINT FRANCIS DR
Second Line	:	SUITE 360
City	:	GREENVILLE
State	:	SC
Zip	:	29601-3971
Country	:	US
Telephone Number	:	864-233-4349
Fax Number	:

Provider Business Practice Location Address
First Line	:	3 SAINT FRANCIS DR
Second Line	:	SUITE 360
City	:	GREENVILLE
State	:	SC
Zip	:	29601-3971
Country	:	US
Telephone Number	:	864-233-4349
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/07/2005
Last Update Date	:	10/31/2014

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